I'm just hopefully looking forward to the future, but what does it look like when you move into maintenance mode with OCD treatment?
I'm looking at moving to every other week with my therapy sessions in a month or two, and I know that meeting once a month is a thing as well. Do you still end up meeting once a month or at some other frequency? What do you do to watch out for new manifestations of OCD?
I know that I should ask my therapist, but she's out of the country for the next month.
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Selesnya
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Hi Selesnya - I wish I could help answer your questions. I've never done ERP. It was hard to get used to not meeting with my doctor weekly when I went back to work years ago. My doctor had me go back to work as part of my treatment. Back then it was so hard to get any time off work that I had to go months without seeing him. That helped break a lot of the dependency on him that had built up. I will probably always feel a little dependent on him. He could have retired years ago, but hasn't. I'm glad he is still there because he is the only one who can comfort me if I start to go down with OCD and/or Depression. The bad part about that is that when I get down, I feel like I don't deserve his help. That makes it hard for me to go see him. As far as being able to prevent future manifestations or occurrences of OCD, or see them coming - I would say take maintenance meds if deemed necessary, watch stress levels and physical health, and learn as much as you can about OCD. We can always hope and pray that more help for & answers about OCD are found for us sufferers. Since your therapist is away this month, you are getting a sample of being on your own for a little while. Having this experience might be helpful when you discuss these questions with your therapist on your next visit.
I think that I need to keep in mind as well, that my therapist is unlikely to push me to do something that she doesn't feel like I'm ready for or capable of doing. I do not have to succeed 100% in resisting compulsions and ignoring OCD before I can work on trying to be more independent in my own care. Having some faith in myself and my ability to cope will go a long ways to actually being able to manage more on my own. I will try not to panic about this and feel overwhelmed, or at least just accept that feeling when it does come up.
I wish that OCD were easier than it is. It still feels unbearable at times, even if I know that I'm doing so much better now than I was a year ago.
Hi Selesnya - I know OCD is very rough, as it robs from us some of the best that life has to offer. I try to remember that everyone has problems and a lot of people have different medical problems they have to deal with, too. Try to take this one day at a time. I know you can do it. We'll all just keep learning together how to cope better.
Hope you are doing well! I will try to answer this question the best I can based off of my own experience. I feel that OCD never completely goes into maintenance mode. I would say I have long spurts with generally no symptoms, but then may have a day or a week of struggle. When I first begin seeing my therapist it was twice a week and now we are down to once a month. We came to this decision together based off of the frequency of my intrusive thoughts and my ability to handle them properly. I believe that you should do whatever feels right for you. If you can get to once a month or even longer that is great, but if not that is also ok in my book. What is important to me is that regardless of how often I see my therapist, I keep myself accountable. At this point I know my OCD well enough to recognize an intrusive thought and make the conscious decision to resist the compulsion. I do give in sometimes - but for me it helps to picture my OCD as a cute a little ball of fluff when it’s managed and know that each time I do a compulsion I feed it and it will grow to be something scary and mean.
OCD is always going to be a constant uphill battle for me, but there will be and has been long stretches of flat road. As long as I continue to do the opposite of what OCD tells me I know that the frequency of the thoughts will lessen. I also began to notice that I was using therapy as a crutch and well it is always nice to know she will be there when I need her, we do have to learn to live with the uncertainty and embrace it in our day to day lives.
In short, if both you and your therapist think every other week is a good idea then go for it! If it works it works and if it doesn’t you can try again. Just remember what you are up against and use the tools you have acquired to beat it. I also find it helpful at times where I go a long stretch without therapy to journal or log some of my daily successes. It helps unclog my mind and gives me something to look forward to by reporting good progress. Hope this is somewhat a helpful answer!
Thanks a lot for your thoughts. You have an admirable outlook on dealing with your OCD and it sounds like things are generally going pretty well for you, even if you have times that OCD flares up again.
I really don't know what I should do. When I was going into therapy my outlook was that I didn't care what it cost, because the choice was killing myself or moving forward with a path that might have some hope and promise to it. I felt that I owed it to my wife and son to try therapy. Now after a bit over a year of therapy I'm to the point of having started to address all of my OCD themes with ERP, but there are topics that I still find completely overwhelming and that interfere with my daily functioning and my ability to sleep. Intellectually I know what to do, but I can't follow through. My therapist and I both know that I have the knowledge to take things on, and there isn't more that I need to learn in how to approach OCD. I just suck so hard at actually resisting my compulsions. Often enough I just find myself giving in to the compulsions so that I can get something done. For example, I've tried to stop listening to OCD podcasts, because I will compulsively listen to them. Yesterday I was too amped up to be able to concentrate on my work, and after a couple hours of making no progress and being in a constantly triggered state, I put on some OCD podcasts to listen to so that I could calm down enough to focus and get some work done. I have a huge task coming up on Monday next week that I think has about a 10% chance of going well. I should have been preparing for this all day every day this week. Instead I've listened to podcasts, read Facebook, checked here, etc. Today when I tried to actually do some prep work, it was two hours of being constantly triggered. I felt like I was going to throw up, my legs kept getting weak, my heart was racing and I was sweating and breathing hard. This is me after a year of working on this topic.
Sorry, this post has gotten a little off the rails. I intellectually know enough to say that I should stay in therapy at least once a week until I can go more than a day without feeling that I'm in a complete struggle with OCD for control. I also know that this last week or two has been at a significantly higher stress level than normal, so maybe I shouldn't evaluate my success based on the last two weeks. Financially I think that I may have to cut back to twice a month or once a month, even if it's not the optimal path for recovery.
Sorry for the delay in my reply! I just read this over and wanted to have some time to craft an adequate response. First, I would like to address the way you talk about yourself. I am reading a lot of negativity and harshness in your words that you do not deserve. What you do deserve is to be kind to yourself and to internally receive the compassion you give to others. Before you say it, I know how difficult that is. My own OCD would not be nearly as bad at times if I could stick to a consistent self love and care routine but we still have to try.
Living with OCD is not something you asked for and unfortunately it is difficult to feel understood with this disorder. There is no cure — only management. There is no wrong place to be in your recovery. With OCD your intellectual reasoning does not matter. If it did, neither of us would be in treatment right now! Just because you think you should be able to handle fewer sessions at a time does not mean that is the right choice for you. I know how expensive this treatment is, even with the help of insurance, but our mental health is absolutely priceless. Going into treatment for your wife and son is extremely admirable but at the end of the day the person you owe it to the most is yourself.
If your OCD is interfering with your ability to sleep and perform at work then I would urge you to go even more frequently for a brief period of time and push yourself to do the exposures that OCD says you are not capable of doing. This is a lifelong journey. You may have trouble resisting compulsions now but that does not mean that you suck or are less of a person for it. You are trying to get better like each and everyone of us. The most beautiful things in this world were not built over night. Do not focus on the past and what you feel you could have done better — the past has already forgotten about you. Put your time and energy into the future and focusing on taming the ugly beast that is OCD.
I wish society could take a peak inside of our brains. Everyday is full of fear and panic but each day we still get up and fight. You getting out of bed is fighting. Brushing your teeth is fighting. Going to work is fighting. Please do not disregard how brave you are for fighting this battle. It is not an easy one. I know how bad the struggle can be, but I also know that there is good ahead even the wake of all the bad. You CAN do this and you do deserve to be happy and mentally healthy. Not many people could handle having OCD if they knew what it truly entailed. But we are able to live our lives regardless. God chose you because he knew you were strong enough to handle it. Keep going and hold onto hope. Praying for you.
Thanks so much for this reply. You are 100% right that it is easier to be compassionate and understanding with someone else than it is to do with myself.
I've read over this from KImberley Quinlan a few times today:
The part that I need to remind myself the most is:
This struggle is real and IMPORTANT. You are not making this struggle up. If it is hard for you, it IS hard. Just because it isn’t hard for others, does NOT discount that it IS hard for you. Be gentle with yourself. You are not dumb, or stupid, or messed up because this struggle is so hard for you. There is no rhyme or reason why this struggle chose you. All I can say is that it is yours and you are correct. IT IS HARD.
I'm trying to work on the self-compassion angle. I'm starting from about 0% self-compassion, and I know that I've made some progress over the last few months but that I have a long way to go. Self-love seems unattainable, but I'm working on the compassion angle. Maybe I'll get there someday.
I will just focus for now on making it through tomorrow as best I can and be accepting of when I mess up. I have pretty much set myself up to fail spectacularly tomorrow and it's too late to back out now. Given that I already know I'm going to fail, I won't be surprised when it happens. I have been pushing myself really hard because I want to show that I'm making better progress than I am. I have not accepted where I am and that the areas that I have left to work on are still an enormous struggle at times.
This feels like such an inadequate reply, but I wanted you to know how much I value your caring, support and concern.
Just a quick update, but my work scheduled for Monday was postponed. I hurt my back over the weekend and I was just lying on the couch on Sunday and Monday and trying not to move too much. The work got rescheduled for Thursday, which gave me enough time to finish my prep for getting ready and to break up my work into about 40 little steps. I was able to keep working through all of my tasks just by taking one thing at a time and not getting ahead of myself and thinking about the whole project (or all of my projects), and just focusing on one small task at a time. I have one task left to finish tomorrow, but I'm mostly complete, and made it through without triggering myself, which has me totally amazed. Hurray for small victories!
For me, my maintenance work is almost entirely self-driven. I've had a single, 30-minute therapy session this year; they simply aren't necessary at the moment. I've been off medication since last June. As long as I'm sleeping well, eating well, exercising 4-5 times a week and sticking to a routine my symptoms are either minimal or, as is more often the case, non-existent. When they flare up I use my therapy tools (aggressively agreeing with the thoughts being the most effective) and manage them.
I know I'm lucky; I know that not everyone can get to this point. But I also worked my butt off to get here, and it was worth every single ounce of energy.
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